BACKGROUND: To pass through the microcirculation, erythrocytes need to undergo considerable deformation. We performed an experiment to investigate the erythrocyte deformability in healthy adults and in patients with uncontrolled hypertension and controlled hypertension. METHODS: 5ml of whole blood is anticoagulated with 2mg ethylenediaminotetra-acetic acid(EDTA). 1ml graduated plastic syringe, without its plunger, is filled with anticoagulated whole blood to the 1ml mark, And the syringe is put into the assembled membrane holder. Under standard condition, whole blood is passed through a 5micro polycarbonate membrane filter under negative pressure of 20cm H2O. The studies are performed at roon temperature and within two hours of venipuncture. RESULTS: Erythrocyte deformability was observed in 91 normal healthy adults and 25 patients with uncontrolled hypertension and 18 patients with controlled hypertension. Following results were obtained. 1) In male control age group I, II, III, the erythrocyte deformability indices were 0.776+/-0.125, 0.792+/-0.189, and 0.714+/-0.172 respectively and in female the indices were 0.880+/-0.138, 0.865+/-0.182 and 0.796+/-0.170 accordingly. 2) THe RBC deformability indices in female control troup were significantly higher than the male group in statistics(p<0.05). 3) No significant differences were observed among each age group in control. 4) In patients with uncontrolled hypertension, each age group I, II and III, the erythrocyte deformability indices were 0.785+/-0.050, 0.775+/-0.122, and 0.692+/-0.133 respectively and in control group, the indices were 0.8365+/-0.140, 0.8252+/-0.186 and 0.7534+/-0.173 accordingly. And in patients with controlled hypertension, the indices were 0.820+/-0.00, 0.788+/-0.135 and 0.716+/-0.141 accordingly. 5) The erythrocyte deformability inddex in patients with uncontrolled hypertension were significantly lower than the control group(p<0.05), and no significant differences were observed among each age group between male and female in patients with uncontrolled hypertension. 6) There was no significant statistical difference of deformability indices between uncontrolled group and controlled group(p>0.05). CONCLUSION: This study reveals that the erythrocyte deformability in patients with essential hypertension is significantly lower than the healthy adults.
Adult ; Erythrocyte Deformability* ; Erythrocytes* ; Female ; Humans ; Hypertension* ; Male ; Membranes ; Microcirculation ; Phlebotomy ; Plastics ; Syringes

No abstract available.
Anemia* ; Erythropoietin* ; Humans*

We experienced a case of aldosterone and cortisol secreting adrenal adenoma associated with pregnancy in a 23 year old female patient.The patient complained of severe thoraco-lumbar pain, weight gain, sweating, anxiety, and mild abdominal discomfort. On physical findings, hypertension, tachycardia, facial plethora, moon face, buffalo hump and truncal obesity were found.
Adenoma ; Aldosterone ; Anxiety ; Buffaloes ; Female ; Humans ; Hydrocortisone ; Hypertension ; Moon ; Obesity ; Pregnancy ; Sweat ; Sweating ; Tachycardia ; Weight Gain

BACKGROUND: The talus has a very complex anatomical morphology and is mainly fractured by a major force caused by a fall or a traffic accident. Therefore, a talus fracture is not common. However, many recent reports have shown that minor injuries, such as sprains and slips during sports activities, can induce a talar fracture especially in the lateral or posterior process. Still, fractures to the main parts of the talus (neck and body) after ankle sprains have not been reported as occult fractures. METHODS: Of the total 102 cases from January 2005 to December 2012, 7 patients had confirmed cases of missed/delayed diagnosis of a talus body or neck fracture and were included in the study population. If available, medical records, X-rays, computed tomography scans, and magnetic resonance imaging of the confirmed cases were retrospectively reviewed and analyzed. RESULTS: In the 7-patient population, there were 3 talar neck fractures and 4 talar body fractures (coronal shearing type). The mechanisms of injuries were all low energy trauma episodes. The causes of the injuries included twisting of the ankle during climbing (n = 2), jumping to the ground from a 1-m high wall (n = 2), and twisting of the ankle during daily activities (n = 3). CONCLUSIONS: A talar body fracture and a talar neck fracture should be considered in the differential diagnosis of patients with acute and chronic ankle pain after a minor ankle injury.
Adult ; Ankle Fractures/*diagnosis/diagnostic imaging ; Ankle Injuries/*diagnosis/diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Sports ; Talus/diagnostic imaging/*injuries ; Young Adult

Diffuse esophageal spasm (DES) is a motility disorder of the esophagus characterized by symptoms of retrosternal chest pain and intermittent dysphagia. The diagnosis of DES has relied on criteria obtained from a standard esophageal manometry (more than one simultaneous contraction in a series of 10 wet swallows with the rest being peristaltic). Because symptoms and/or typical manometric findings are not always documented during the standard manometry, 24 hour manometry may be more useful in such cases. We recently assessed a 29-year-old male patient who complained of chest pain and dysphagia. He showed nonspecific findings on the laboratory based manometry, but DES was diagnosed by his typical manometric findings on the 24 hour manometry. Therefore, a 24 hour manometry should always be performed when the patient's history suggests the presence of DES and the laboratory based manometry failed to detect the symptomatic contractions of DES. Following we report this case with a review of the literature.
Adult ; Chest Pain ; Deglutition Disorders ; Diagnosis* ; Esophageal Spasm, Diffuse* ; Esophagus ; Humans ; Male ; Manometry* ; Swallows

PURPOSE: The purpose of this study is to describe the characteristic high-resolution(HR) Ct findings ofsolitary nodular bronchioloalveolar carcinoma(BAC) of the lung which are valuable for specific diagnosis of thedisease. MATERIALS AND METHODS: HRCT scans of 46 patients (31 with malignant and 15 with benign lesion) with asolitary pulmonary nodule seen on chest radiograph were distributed in random order and analyzed retrospectively.Two blinded observers jointly analyzed the marginal and internal characteristics of nodules as seen on HRCT, anddecisions on the findings were reached by consensus. Stepwise discriminant analysis for characteristic findings ofBAC was performed. RESULTS: The most frequent CT findings of BAC (n=15) were internal bubble lucency (14/15,93%)(p=0.001), area of ground-glass opacity (12/15, 80%;average 58% of tumor volume)(p=0.0001), pleural tag(12/15,80%;p=0/097), and lobulated and spiculated margin(8/15, 53%;p=0.459). Findings of ground-glass opacity(p=0.0001)and bubble lucency(p=0.0187) appeared to be discriminantin the diagnosis of BAC. CONCLUSION: Peripheral pulmonarynodules containing an area of ground-glass opacity associated with internal bubble-lucency are characteristic ofBAC. Specific histologic diagnosis of solitary nodular BAC can be suggested by careful analysis of HRCT findings.
Adenocarcinoma, Bronchiolo-Alveolar* ; Consensus ; Diagnosis ; Humans ; Lung* ; Radiography, Thoracic

BACKGROUND/AIMS: Generally, it is recommended for patients with gastroesophageal reflux disease to sleep with the head of the bed elevated; however, many patients in Korea do not have heartburn symptoms during the night. METHODS: We investigated the pattern of acid reflux in patients who were diagnosed as having definite pathological acid reflux on 24-hour pH monitoring. RESULTS: One hundred patients were categorized into 3 groups; upright refluxer (68%), supine refluxer (2%), or combined refluxer (30%). Acid reflux was rare in supine positions but instead, usually occurred in upright positions. Acid reflux was found to occur most commonly after meals. The reflux symptoms occurred during pH monitoring with the average frequency of 5.5 times (total of 254 times) in 46 patients. The acid related symptoms were more common in the upright period and postprandially than the supine period. The presence of an esophagitis, an esophageal motility disorder, or the LES pressure did not make a significant difference between upright refluxer and supine refluxer. CONCLUSIONS: Gastroesophageal reflux was found to be rare in supine positions but usually occurred in upright positions. Gastroesophageal reflux occurred most commonly after meals, and was frequently associated with reflux symptoms.
Esophageal Motility Disorders ; Esophagitis ; Gastroesophageal Reflux* ; Head ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Korea ; Meals ; Supine Position

Pulmonary sclerosing hemangioma is a relatively rare neoplasm of the lung with polymorphic histologic features of 2 unifying cellular components including surface cuboidal cells and interstitial round cells. Pulmonary sclerosing hemangioma typically occurs in middle aged women with asymptomatic, peripheral, solitary, well-circumscribed lesions. Although it is pathologically benign, it reveals size growing and chest symptom. We here report a case of pulmonary sclerosing hemangioma in a 72-year-old woman. She presented chest discomfort. A chest radiography and a chest computed tomography scan showed growing size from 3.2x3.1 cm to 6.0x5.3 cm in left upper lung during 10 years' follow-up period. Surgical resection of lung revealed a distinct constellation of findings including 2 epithelial cell types, surface cells, and round cells, which form 4 architectural patterns, papillary, sclerotic, solid, and hemorrhagic. She was diagnosed as pulmonary sclerosing hemangioma and chest discomfort disappeared.
Aged ; Epithelial Cells ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Diseases ; Middle Aged ; Pulmonary Sclerosing Hemangioma ; Thorax

Microsatellite Repeats*

A 29-year-old man was admitted because of melena for 5 days. Two years ago, he underwent allogenic bone marrow transplantation for chronic myeloid leukemia and received immunosuppressive agents. Esophagogastroduodenoscopy showed a picture - multiple scattered deep ulcers and friable pseudomembranes - of highly suggestive of a herpes simplex esophagitis and biopsy revealed multinucleated giant cells and pathognomonic intranuclear inclusion bodies. Esophageal lesions and melena improved after acyclovir therapy.
Acyclovir ; Adult ; Biopsy ; Bone Marrow Transplantation ; Endoscopy, Digestive System ; Esophagitis* ; Esophagus ; Giant Cells ; Herpes Simplex* ; Humans ; Immunosuppressive Agents ; Intranuclear Inclusion Bodies ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Melena* ; Ulcer